Overloaded schedules and ‘Covid cowbells’: For pharmacists, the Covid-19 vaccine rollout brings exhaustion, but some relief

The nationwide frenzy to get Covid-19 vaccines has been complicated, frustrating, and downright exhausting for millions of Americans. But take a moment to consider the plight of your local pharmacist.

Working with limited supplies and imperfect scheduling systems, many are drowning under a flood of inquiries. Wait lists, where they exist, are getting longer. And even creative solutions are succumbing to the cold realities of the day.

Bartle’s Pharmacy of Oxford, N.Y., for instance, tried employing a few college students who were on winter break to handle calls scheduling Covid-19 vaccine appointments. That setup lasted a day because the phone system couldn’t handle the calls coming in.

Amid the tension, Heather Bartle-Ferrarese, a pharmacist and co-owner of the store, said she and staff have tried to lighten the mood. They now have a “Covid cowbell” that patients can ring after they get their shot, to let everyone know they got vaccinated.

“It’s pretty amazing to see the relief on people’s faces,” Bartle-Ferrarese said.

Pharmacies play a key role in the expanding national vaccine rollout, which has been hampered by supply issues and maddening searches for appointment slots. This week, 1 million doses are being shipped to 6,500 retail pharmacies across the country, including CVS, Walgreens, and Walmart locations, in a partnership with the federal government that’s expected to grow to 40,000 major chain pharmacies. And more than 90% of U.S. residents live within 5 miles of a pharmacy, according to the National Association of Chain Drug Stores.

A few weeks after Eric’s Rx Shoppe in Horsham, Pa., put up a Covid-19 vaccine scheduling system on its website in early January, it buckled under intense demand. The state had just allowed additional priority groups to receive the vaccine, and the roughly 200 appointment slots allocated for each day quickly became double, then triple, then quadruple booked.

“We had to shut that down,” said owner Marc Ost. “It was just being overloaded, it couldn’t handle that.”

Eventually, the store switched to another system, which Ost said doesn’t have the same issue with multiple bookings. But demand for the vaccine has expectedly remained high — the store recently opened up about 180 appointment slots, only to have them fill up in about a minute and half.

“We have people call and say, I called and got my name on the waiting list a few weeks ago, why haven’t you called me for a dose yet?” said Sara Massey, a pharmacist at Caldwell Pharmacy in Wynne, Ark., which serves a town of around 8,000 residents and is the largest of three independent pharmacies giving the vaccine in the county. 

Massey said demand has skyrocketed as the state extended vaccine eligibility to teachers, in addition to health care workers and those over 70: Her store has over 1,000 people on its waiting list. She had been getting 100 doses every week, but was told in early February that her pharmacy would start splitting the same amount between the two other independent pharmacies in the county.

Like Eric’s Rx Shoppe, Bartle’s Pharmacy had to come up with a new system — in its case, a dedicated email address for patients to schedule an appointment. That works better, Bartle-Ferrarese said, but the store has still struggled to keep up, especially because it gets an inconsistent supply of doses from the state — sometimes 300 a week, sometimes less. At her last count, there were about 1,400 people on the waiting list. 

Pharmacists said extreme demand for the vaccine has gone hand-in-hand with a slew of administrative challenges. Abby Rice and her husband own two pharmacies in rural Kansas, including Ward Drug in Oberlin, which is the only pharmacy in town and has been the sole administrator of Covid-19 vaccines in the county. The wait list for the vaccine is much shorter than in some other places — around 350 when Ward Drug first started giving out the vaccine in January, which Rice said has since gone down. But from keeping the vaccine doses cold and making sure they don’t expire to scheduling the appointments and just running the rest of the store, Rice said this has been an unprecedented challenge. 

“Once you puncture a vial, you’ve got six hours to use those 10 doses,” she said, referring to the Moderna vaccine the stores use. “So you kind of got to be careful of when you schedule that. And then being mindful of the times of the second dose and making sure you hold clinics close together.”

Eyad Farah, the president of independent pharmacy franchise Health Mart, said stores across the country are trying to cope with the challenges that far surpass typical pharmacy vaccination efforts, such as pre-vaccination screening, staffing, storage and handling requirements, and avoiding vaccine waste. Health Mart helps operate stores like Bartle’s in Oxford, allowing each pharmacy to remain independent, while also taking on administrative tasks like procuring vaccines for stores from the federal government.

Chain stores, too, are anticipating more calls and administrative work as they receive an increase in vaccine doses. Justin Ellis, depot leader for CVS’s Covid-19 vaccine supply in Arizona and a pharmacy manager at a CVS in Laveen, is one of nine people in charge of the drugstore giant’s vaccination efforts in Arizona. So far, most CVS stores, including his, have not given out the vaccines to the general public, but pharmacists have gone to long-term care facilities to vaccinate residents and employees. Ellis said it’s been fulfilling to both personally vaccinate people and to help lead CVS’s vaccination program.

“It’s been pretty life-changing for me,” said Ellis. 

Like many across the country, he has been personally impacted by Covid-19, and knows how badly the vaccine is needed. He said that while going through trainings to prepare for the vaccination program, he found out that a family member had died from Covid-19, and he’s had several other relatives die from or be hospitalized with the disease. 

“These outreach programs that we do really hit close to home,” he said. 

Pharmacists said there are other hurdles as vaccinations continue to expand. 

“I think one of the biggest things would be around vaccine hesitancy. … We need to do some community-based awareness and education campaigns to help some of those underprivileged or underserved communities,” said Ellis, who is Black, and whose pharmacy serves a large Black community.

Rice said that hesitancy is something her husband, Chase, the pharmacist at both stores, deals with all the time in their rural community, but it helps that community pharmacists like him are trusted by their customers and can help sway people. 

Bartle-Ferrarese said she worries that her store’s email system is inaccessible to older residents. She said a 91-year-old woman recently called the store looking to get the vaccine, but didn’t leave her name or phone number. With the store’s current phone system, they have no way to reach her or even to know who she is. 

Nevertheless, pharmacists are learning on the job, and say they are more than willing to put in the extra work to vaccinate their communities. “This is a learning curve for everyone involved,” said Bartle-Ferrarese. But pharmacists have always been crucial parts of their community’s health, said Rice, and the massive Covid-19 vaccine campaign is no different. 

“This is what we do,” Rice said.